Legislation cuts heart out of nursing home regulations, advocates say

Saturday

Mar 31, 2012 at 12:01 AMMar 31, 2012 at 8:49 AM

SPRINGFIELD -- Advocates for nursing home residents are livid after the Illinois House last week unanimously approved a bill that apparently would make it harder for the state to cite and fine homes after a resident has been injured or killed.

DEAN OLSEN

SPRINGFIELD -- Advocates for nursing home residents are livid after the Illinois House last week unanimously approved a bill that apparently would make it harder for the state to cite and fine homes after a resident has been injured or killed.

One advocate said House Bill 5849, sponsored by Rep. David Leitch, R-Peoria, would roll back much of the state’s 2010 landmark nursing home reform law and put more residents at risk.

“This is how nursing home reform dies,” said Wendy Meltzer, director of Chicago-based Illinois Citizens for Better Care. “Nursing home reform doesn’t die in a big, splashy way, where everybody pays attention and you go, ‘Oh my God, what a big thing that was.’ Nursing home reform dies quietly and on the edges by making it bureaucratically impossible to implement nursing home reform, and that’s what this is.”

Leitch told The State Journal-Register that opponents of his bill are “misinformed.”

He said the opponents, which also include AARP Illinois, actually should support the legislation “because it’s more-uniform regulation of the most serious violations. It’s better regulation, because there’s a lot of disconnect around the state as far as the application of some of these rules.”

The bill, which is not being opposed by Gov. Pat Quinn or his aides at the Illinois Department of Public Health, passed the House on a 114-0 vote Tuesday and goes on to the Senate. Quinn signed the reform law to much fanfare in 2010.

Too tough?

Leitch’s legislation requires the state to establish a statewide team that would review “all alleged Type ‘AA’ or Type ‘A’ violations” for fairness compared with similar situations in the past. Only then could Public Health could issue one of the two high-level citations or consider a fine.

As part of the review, the bill says the team “shall analyze all available data and precedents for the purpose of ensuring that determination of violations are consistent throughout the state.”

Greg Wilson, a vice president at Peoria-based Petersen Health Care — which suggested that Leitch introduce the legislation — called the proposed evaluation process “common sense.”

He said Petersen Health Care, a 38-year-old company owned by Peoria resident Mark Petersen, has seen inconsistencies when state rules have been applied by Public Health surveyors against Petersen’s more than 60 nursing homes across the state.

Leitch said Illinois is unnecessarily tough on nursing homes compared with regulators in other states.

Leitch’s bill probably would add only 15 minutes to the state’s process of reviewing a nursing home’s inspections to determine whether a violation should be cited, Wilson said.

Meltzer disagreed. She said the bill would result in fewer nursing homes being cited or fined.

The bill doesn’t say how far in the past the review team must look for comparable situations, she said.

“Is it two years, five years, the dawn of time?” she asked.

State law already requires Public Health officials to go through a review process, known as “quality control,” before issuing citations or fines, Meltzer said, and officials have a 90-day deadline between when a violation is spotted by a surveyor and when a citation can be issued.

Some potential violations end up being thrown out because Public Health has missed the deadline, she said.

“They’re not going to have one review system; they’re going to have two review systems,” she said.

Under the radar

Meltzer said the bill, which isn’t being pushed by either of the nursing home industry’s two major lobbying groups in Springfield, would set up often-insurmountable bureaucratic obstacles for the state’s overwhelmed nursing home surveyors.

“Every time you reduce the likelihood that there’s going to be a penalty, and in this case we’re pretty much reducing it down to a single percentage because they are not going to meet the time deadlines, you’ve just gutted enforcement through a back door without even saying that’s what you’ve done,” Meltzer said.

AARP associate state director David Vinkler said the additional bureaucratic hurdle also would make it easier for nursing homes to get violations thrown out on appeal.

Meltzer said she faults Public Health officials, not lawmakers, for the bill’s passage in the House during a busy week at the Capitol. Public Health’s lack of opposition to the bill probably carried a lot of weight with lawmakers, she said.

Vinkler said Public Health officials should have told him and other consumer advocates that the department had withdrawn its original opposition.

Public Health spokeswoman Melaney Arnold said the department became officially neutral on the version of the bill that passed, after Leitch agreed to some rewording — rewording that Vinkler said still puts nursing home residents at risk.

Arnold said: “It’s not a perfect bill. We will continue to work with the sponsors. We certainly have some concerns, too.”

She wouldn’t elaborate on the department’s concerns.

“We will address those moving forward,” she said.

Arnold said a rollback of the 2010 law is “certainly not something that we want to see, either.”

Vinkler said: “The bad part of this from the consumer’s point of view is that reviewing every incident of an ‘A’ or ‘AA’ violation is going to take time. And if you know that there’s something already that has resulted in somebody’s injury or death, you should take immediate action on that. There’s no reason to delay.”

Dean Olsen can be reached at (217) 788-1543. Follow him at twitter.com/deanolsen.

More information

According to the Illinois Department of Public Health, Peoria-based Petersen Health Care has an ownership interest in 67 nursing homes statewide, including facilities in Bloomington, Canton, Champaign, Decatur, East Peoria, Havana, Kewanee, Nokomis, Pittsfield and Toulon. A list of the facilities, along with a map, are available at http://bit.ly/petersenfacilities.

*More information about Petersen Health Care is available at www.petersenhealthcare.net.

*Information about individual nursing homes — such as ownership, bed statistics and Medicare/Medicaid funding — can be looked up at http://tinyurl.com/ilnhomes.

*Complaints about individual nursing homes can be filed by calling the Illinois Department of Public Health’s Hotline at (800) 252-4343.

Nursing home discipline

The difference between a “citation” and a “fine” against a nursing home:

*A citation is a written statement by the Illinois Department of Public Health that the department believes a nursing home has violated state law dealing with the quality of health care and safety provided to nursing home residents. The most serious violations -- “AA” or “A” citations –- usually prompt Public Health to eventually issue fines as well, but lower-level citations don’t always lead to fines. A citation becomes public record and is needed before a fine can be levied.

*A fine can be disputed through an internal system set up by Public Health and also can be contested in court. Nursing homes often settle fines by negotiating to pay Public Health reduced amounts.

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